The role and development of local, joint-working protocols

Written procedures that are agreed by all agencies
are key to ensuring that support is delivered effectively
to people whose needs cross service boundaries.

Services for supporting parents with additional
requirements and their families are necessarily spread
over a number of services and agencies, each working
to different priorities, budgets, time frames and,
to an extent, legislation. Yet there is increasing
emphasis throughout the UK on the need for joined-up
working to safeguard and promote the welfare of children.
In England this has coincided with the organisational
separation of children’s and adults’ social
care services. If existing differences between the
services are not to grow wider still then there is
an urgent need to develop effective links across
services for children and specialist services for
adults. It is therefore more important than ever
to develop agreed procedures and approaches to address
the following issues:

the needs of families where parents have additional
support requirements which, if not met, may have
a negative impact on their children’s welfare

disagreements
between adults’ and children’s
social care about their respective responsibilities
and who should meet costs

lack of clarity about
responsibility for assisting parents with specific
challenges, such as which service should provide
parenting classes or support for getting their
children to school

organisational barriers to good
communication and a lack of shared understanding
of aims, roles and responsibilities

families where
neither the adult’s nor the
children’s needs meet the threshold criteria
to receive services when considered in isolation
from one another.

The benefits of universal and specialist protocols

A universal protocol is one that encompasses a range
of additional support needs, although it may also
refer to procedures which will apply in certain circumstances.
Some agencies have developed an overarching universal
protocol that lays out the general principles of
supporting parents with additional requirements and
the procedures to be followed. In other places, agencies
have developed protocols that cover particular groups
of parents, such as those with mental health support
needs or those with learning disabilities. Some agencies
have also developed protocols covering specific circumstances,
such as where a pregnant woman with additional support
needs requires multi-agency support.

A key advantage of a universal protocol, when used
in addition to specific procedures covering particular
groups of parents, is that it establishes the principle
that support should be made available to all parents
in a way that families experience as non-stigmatising
and approachable. The division of services into relatively
impermeable compartments can be a source of great
frustration and difficulty for families whose needs
span administrative categories. A universal protocol
means that possibilities for continuity and flexibility
are maximised, and provides a framework within which
specialised services can be accessed as and when
needed.

The good practice survey conducted for the SCIE
knowledge review 11 illustrated the importance
of a universal protocol in supporting parents effectively
in a wide range of situations. The good
practice examples demonstrated that universal
protocols clarify the arrangements to be followed
in a range of circumstances, from situations in
which children’s services will not necessarily
be involved, through to complex, urgent and difficult
situations that involve both adults’ and
children’s services teams. A universal protocol
to which all relevant services are committed makes
it easier to achieve continuity without undue dislocation
as and when urgent needs and crisis situations
arise. It also provides a firm foundation and framework
for the development of protocols to cover specific
groups and situations.

Developing protocols: common goals and local application

The preparation of local protocols frequently arises
out of local awareness that the needs of some parents
and their children are not being adequately met.
Protocols have also been developed in response to
specific difficulties that have arisen when service
divisions and agencies have worked together. In fact,
the good practice survey found that developing joint-working
protocols is an important part of the process of
achieving joint-working between agencies. Furthermore,
as has been said elsewhere, 'the collaboration
required to produce them [protocols] is also a model
for good working practices in applying them’.(1)

At the same time it is useful to be able to draw
on other agencies’ experiences of developing
joint protocols. While the specific context will
always be relevant to the development and content
of local protocols, there is great value in learning
from other agencies’ experiences of tackling
challenges.

Parents a protocol should cover

All the good
practice examples of joint protocols have adopted the broad and inclusive definition of 'disabled
parents’ employed by the Joseph Rowntree Foundation’s
Task Force on Supporting Disabled Adults in their
Parenting Role. This definition includes:

parents who may have additional requirements
related to physical and/or sensory impairments

parents
with learning difficulties/disabilities

parents with
mental health problems

parents with drug and alcohol-related
problems

parents with serious illnesses such as HIV/AIDS

parents
who identify as 'Deaf’ (see note below)

parents
who may or may not identify with the term 'disabled’.

Note: The
term 'Deaf’ (with a capital 'D’)
is used to describe someone identifies as part
of the Deaf community and who uses British Sign
Language (BSL). The term 'deaf’ (with
a lower case 'D’) refers to someone
with a hearing impairment who may or may not
use BSL.

This guidance covers two broad groups of parents:

People who come under the legal definitions of disabled
person used by community care legislation and/or
the Disability Discrimination Acts 1995 and 2005.
In brief, this means people who are substantially
and permanently affected by physical and/or sensory
impairments, long-term medical conditions, learning
disabilities or mental health problems.

A larger group of parents who have support needs
in addition to those of most parents. This group
includes parents with: physical and/or sensory impairments;
permanent and/or long-term health problems; learning
disabilities; and mental health problems. It does
not include parents whose difficulties do not meet
the 'substantial’ and/or 'permanent/long-term’ criteria
contained in the two legal definitions of 'disabled
person’. This larger group also includes parents
who have problems related to drugs and/or alcohol.
Some of these parents will meet the legal definition
of disabled person because of impairment/illness
associated with their drug and/or alcohol use. SCIE
knowledge review 11 provides an overview of the
estimated numbers of parents in each of these categories.

The knowledge review on which this guide
is based found that for services to become more genuinely
inclusive they need to be more responsive to the
cultural requirements of black and minority ethnic
groups, and other groups such as Deaf people. The
review also highlighted the importance of addressing
more consciously the needs of disabled fathers, disabled
kinship carers and grandparents and non-disabled
kinship carers and grandparents who are involved
in caring for the children of disabled relatives.

Involving parents is key to developing successful protocols

Pressure from parents has sometimes prompted local
authorities to improve communication with parents
and the coordination of responses to parents’ needs.
Disabled people in particular have prompted and been
involved in the development of protocols in many
places. However, there would seem to be very little
involvement of parents with mental health problems
and/or drug and/or alcohol problems in the development
of protocols and policies for partnership working.
It is important to involve a range of parents in
the development of protocols and to make particular
efforts to involve under-represented groups whose
points of view are seldom heard. There is a section
in this guide about involving
parents in developing protocols.

Studies of joint-working protocols for supporting
parents with additional requirements have noted a
qualitative difference between protocols where parents
have been involved (2)(3)
in their development and those where parents have
not been involved. The issue of approachability in
particular is more likely to be addressed in the
former.

Agencies and professional groups a local protocol might cover

No single agency or professional group can meet
all of the needs arising in families where there
are disabled and/or ill parents. Local protocols
provide an opportunity to establish working arrangements
that systematically involve relevant participants
across health, social care, housing, parenting support,
welfare rights, advocacy, early years’ services
and education in the statutory and voluntary sectors.

A range of non-statutory bodies were also involved
in some places, particularly in the consultation
phases of developing the protocols. These included
local and national disability organisations, welfare
rights advisory services, parenting and family support
services (including Sure Start), counselling and
advocacy services and young carers’ projects.

While adults’ and children’s social
care services are the key statutory services involved,
careful consideration should also be given to the
need to work with other agencies and professions
with which families are likely to come into contact.
Once inter-agency cooperation on supporting parents
is in operation it has been found that specific gaps
can be more readily identified and addressed.

For
example, gaps and difficulties can be identified
in:

the provision of support for parents with learning
disabilities/difficulties between ending contact
with maternity services and children starting school

Given the wide range of statutory and voluntary
sector services which have a role in supporting families
with parents who have additional support requirements,
it would be unwieldy to form a working group that
represented all local organisations and services
that need to be aware of and part of the protocol.
At the same time it is vital for its success that
relevant services are familiar with the protocol
and have a sense of ownership over it.